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2021

ANUÁRIO DO HOSPITAL
DONA ESTEFÂNIA

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VACCINES NOT INCLUDED IN PORTUGUESE VACCINATION PROGRAMME IN PATIENTS WITH JUVENILE IDIOPATHIC ARTHRITIS UNDER IMMUNOSUPPRESSION TREATMENT

Filipa Furtado1, Margarida Ramos2, Maria Joao Brito1

1- Pediatric Infectious Diseases Unit, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisboa 2- Pediatric Rheumatology Unit, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisboa

- 8th World Congress on Pediatric Infectious Diseases, Cape Town, South Africa, 19-22/11/2013

Background: Patients with juvenile idiopathic arthritis (JIA) with immunosuppressive treatment are at high risk of infections, some of them can be prevented by vaccination.
Aims: to evaluate the coverage of vaccines not included in the national vaccination programme (NVP) in those patients.
Methods:  Retrospective  study  between  2006  and  2012.  Varicella  vaccine  (VV), seasonal influenza (FluV), pneumococcal (PnV) and hepatitis A vaccine (HAV) were studied. Clinical processes were consulted and telephonic interviews were made to know the vaccination status.
Results: A total of 56/71 patients were included with a median age 10,48±5,05 years.
At  diagnosis  of  the  disease  82.1%  of  patients  had  NVP  updated.  There  were vaccinated  with  other  vaccines  prior  immunosuppressive  therapy;  corticosteroids, methotrexate, cyclosporine or biologic in 35 (62,5%) cases, two of these drugs in 15 (26,8%) and three or more in 6 (10,7%) cases.
62,5% had the FluV and 91,4% weren´t infected (p=0,03). 75.9% had the VV with one  dose  and  three  (14,3%)  children  (two  with  methotrexate  and  one  with methotrexate    and    biologic)    had    varicella-zooster    infection    and    required hospitalization (p=0,3). HAV was done in 44,6% of cases with no vaccinal failure. Eleven (19,6%) children were vaccinated with pneumococcal polysaccharide vaccine and 25 (44,6%) with pneumococcal conjugated vaccine and there was no case of invasive  pneumococcal  disease.  For  parents  PnV  (48/56)  is  the  most  important vaccine and FluV the least (51/56)
Conclusion: Our vaccination coverage is higher than the results founded in other similar international studies. Nevertheless vaccination protocols for this risk group should be done and implemented in daily clinical practice.

Keywords: Vaccines, Juvenile Idiopathic Arthritis, Immunosuppressive Treatment.